Individual provider Active NPI

John Aaron Kirk, PA-C

  • Physician Assistant
  • Fredericksburg, VA
National Provider Identifier
1114991916
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-00517 Issued in NC
Practice address
5825 Plank Rd
Fredericksburg, VA 22407-5207
Phone
(540) 785-3448
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110840725 VA
Physician Assistant 363A00000X 0010-00517 NC Primary

Addresses

Primary practice location

5825 Plank Rd
Fredericksburg, VA 22407-5207

Mailing address

549 Graphite TRL
Chesapeake, VA 23320-3439
Phone (910) 813-3876

Other practice location 1

215 S Hughes Blvd Ste A
Elizabeth City, NC 27909-4108
Phone (252) 338-3166 ext. 2859

Other identifiers 3

IdentifierTypeStateIssuer
0110840725OtherVALICENSSE
0010-00517OtherNCLICENSEE
P00419382OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060203000477 VA Practitioner - Physician Assistant 1254345713 Reassigns benefits to 2 organizations
I20070104000052 NC Practitioner - Physician Assistant 1254345713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Velocity Urgent Care LLCGroup PAC ID 7618234980, 84 clinicians

Practice addresses (Care Compare)

1001 Centerbrooke LN
Suite 100
Suffolk, VA 23434-8663
Phone (757) 702-8105

1944 Centerville Tpke
Suite 100
Virginia Beach, VA 23464-6839
Phone (757) 362-9067

20209 Sentara Way
Carrollton, VA 23314-3573
Phone (757) 542-1100

2168 General Booth Blvd
Suite 510
Virginia Beach, VA 23454-5804
Phone (757) 702-8122

2859 Virginia Beach Blvd
Virginia Beach, VA 23452-7613
Phone (757) 395-1300

3815 Conlon Way
Elizabeth City, NC 27909-9999
Phone (252) 580-2002

4374 New Town Ave
Williamsburg, VA 23188-2865
Phone (757) 984-6140

4701 Virginia Beach Blvd
Suite 210
Virginia Beach, VA 23462-7790
Phone (757) 702-8110

5659 Pkwy Dr
Gloucester, VA 23061-3792
Phone (804) 210-1005

7394 Harbour Towne Pkwy
Suite 5
Suffolk, VA 23435-3473
Phone (757) 702-8116

7435 Granby St
Norfolk, VA 23505-3406
Phone (757) 702-8101

747 J Clyde Morris Blvd
Newport News, VA 23601-1538
Phone (757) 736-3680

920 E High St
Suite 102
Charlottesville, VA 22902-4850
Phone (434) 290-1226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-00517NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Occupational Health P.C. CurrentSince Sep 19, 2014 Accepting new patients
Velocity Urgent Care, LLC CurrentSince Apr 23, 2019 Accepting new patients
Quick Med Inc Past Accepting new patients

Locations

1110 Kildaire Farm Rd
Cary, NC 27511
Phone (919) 481-0277

3815 Conlon Way
Elizabeth City, NC 27909
Phone (252) 580-2002

4374 New Town Ave
Williamsburg, VA 23188
Phone (757) 772-6124

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1114991916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 GRAPHITE TRL",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203439",
            "telephone_number": "910-813-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 PLANK RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224075207",
            "telephone_number": "540-785-3448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 S Hughes Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Elizabeth City",
            "state": "NC",
            "postal_code": "279094108",
            "country_code": "US",
            "telephone_number": "252-338-3166 x2859",
            "fax_number": "252-333-3774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRK",
        "first_name": "JOHN",
        "middle_name": "AARON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2023-03-07",
        "certification_date": "2022-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110840725",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSSE",
            "identifier": "0110840725",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSEE",
            "identifier": "0010-00517",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00419382",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.